The
Growth of Pharmacy in
Medieval Times
I
turned the steering wheel inside of my 1996 Jeep to fit it perfectly
inside the lines of a parking space outside the doors of Walgreens. I
sat in my car for a moment gazing at the commercial building in front
of me. I could not stop thinking about the information Melinda
had told me yesterday about the beginnings of pharmacy in the
ancient
world. I remembered a line I once read in the
great classic, The
Canterbury
Tales "There was a Doctor of
Medicine; In all this world there was non like him, To speak of
medicine and surgery." I wondered when it was that
pharmacy had become its own practice. Pushing open my car door,
I walked up the sidewalk and through the automatic sliding doors.
When did the first pharmacy open and how did it evolve into the
"Walgreen" pharmacies of today? I continued to ask myself questions as
I briskly walked the length of the store to punch the time clock.
I had the basic training of pharmacy - like how to fill and
measure the bottles and what the laws regarding
pharmacy were.
However, as a
simple pharmacy tech, I had not been taught all of the history of
pharmacy in school. Maybe Melinda would help enlighten me again. I found Melinda bent over some shelves behind the pharmacy counter. "Melinda, can you tell me some more about the history of pharmacy? For example, what happened during the medieval period? Did people blame all illness on God and practice medicine superstitiously, and when did pharmacy actually become a recognized profession?"
Melinda looked up and grinned. "So many questions! Of course! I would be delighted to answer all of them and more!"
She straightened herself and handed me a thick book. "I thought you might come to me with more questions, so I decided to give you this book."
"Wow!" I gasped. I read the cover out loud as best I could. "De Materia Medica and Other Records In the History of Pharmacy?"
Melinda nodded. "As ancient medicine expanded into medieval times, documentation and theories of pharmaceutical practices became more numerous. The book I handed you, De Materia Medica and Other Records In the History of Pharmacy, contains one of the most important records showing the widespread use of drugs. That record, among others, revealed that the medieval years were an incredible time of diversification and growth in the practice and use of medicine. However, many of the same stereotypes, from ancient medicine practices, decided to once again manifest themselves in medieval times. Contrary to much popular belief, not all diseases were seen as the punishment of God, nor was the practice of medicine during the medieval period solely a superstitious practice. Rather, this time period was the establishment of pharmacy as its own profession and not a part of some 'Dark Age' thinking. "
"Okay." I said puzzled. "How did they explain ailments? Did they really understand things like bacteria and germs?"
Melinda shook her head. "While it might have been possible to find those who still clung to the thought that God sent diseases and sicknesses as punishment for human sins, most of the physicians and practitioners of medieval medicine understood that illness could be traced to 'complexion or temperament, determined by the balance of the four elements and their corresponding qualities (hot, cold, wet, dry) in the person's body.' (Lindberg 333). If there was an imbalance of any one of these elements, sickness was believed to have been inevitable. This was founded after the theory of Hippocratics, who years ago had written that, "man has in itself blood, phlegm, yellow bile and black bile; these make up the nature of his body, and through these he feels pain or enjoys health' "(On the Nature of Man, On the Sacred Disease, Hippocratic Oath).
"I'm sorry, who was Hippocratics?" I interjected quickly.
Melinda answered me with a smile. "Don't apologize, you can interrupt to ask a question like that. Hippocratics was often known as the 'Father of Medicine'. He started that whole four elements thing I already mentioned and he, too, did not believe that all afflictions were caused by divine wrath, but rather, 'has a natural cause from which it originates like other affections' " (On the Nature of Man, On the Sacred Disease, Hippocratic Oath).
"Was that the only theory for how people became ill?" I asked.
"No," Melinda said quickly. "Other skilled doctors believed that miasma, which 'was corruption or pollution of the air by noxious vapors, containing poisonous elements that were caused by rotting, putria matter, and which were spread by wind,'(Benedictow, 3) might also have been a leading cause."
"Okay, so herbal drugs, were the first remedies most commonly used, though, right? Is that what this book is about I have in my hand?" I questioned.
"Yes! That book in your hand is a list of hundreds of known plants and herbs illustrated and described in detail by Discrodies. For example, Asaran is described in those pages as a plant with leaves, a flower, and a very long root that 'helps herma, convulsions, old coughs, difficulty in breathing, and difficulty in urinating' " (De Materia medica).
"Wow" I said in amazement. "That is a lot of plants to record and draw in one book. This book must have had quite the impact on medieval society".
Melinda nodded emphatically. "With the invention of the printing press, this book was mass-produced and used, not only by physicians and other medicine practitioners, but also by laymen. Its outreach extended not only in Europe. His book also listed out many useful drugs and treatments. Medicine was clearly not only a superstitious practice if it was clearly detailed and outlined in such books using natural growing plants. Application of such drugs was not some mysterious practice but rather just simple mixtures of natural ingredients."
"Okay, then how did they begin to think that medicine was superstitious?" I asked curiously.
"Because of the medicine practices that were done in conjunction with the mysteries of alchemy and astrology." she answered mysteriously.
"Alchemy and astrology?"
"Believe it or not, pharmacy was often practiced within the art of alchemy and astrology. Alchemy was not only defined as it is thought today, to make gold or silver, but rather, it was also to prepare medicines. Chemistry was seen as useful to the practice of medicine because it was during the medieval period that drugs were expanded to encompass not only herbs, but also animal parts and chemicals. For instance, 'mercury cured diseases of the skin,' (Magner, 179). Paracelsus is probably the most well known alchemist and physician who challenged the standing theory on medicine. He taught, in contrast to Hippocratics, 'disease was the result of derangements in the chemical functions of the body rather than a humoral disequilibrium.' (Magner 171). Paracelsus also believed in natural causes of illness; however, not in divine punishment for sins. His research and medical practices were not superstitious in nature."
"What about astrology?"
"It is true that astrology and astronomy played a large role in the realm of medicine during this time. It is clearly stated in many documents, including even The Canterbury Tales, that planetary motion and the stars were often viewed as plausible explanations for ailments, especially epidemic plagues such as the Black Death." Melinda paused and looked at me as if to see if I was throughly understanding everything she was saying.
I nodded at her. "I understand everything so far. So when did pharmacy actually become its own practice? When did the first pharmacy open?"
"A German Emperor by the name of Frederick II issued a Magna Charta in 1240. It officially established pharmacy as its own individual profession. This decree regulated three different things which you can find listed in that book you have there. (Magna Charta) This decree also helped pave the wave for required degrees and certifications from universities before pharmacy could be practiced."
"So when did the first pharmacy open?" I repeated.
"The first was opened in Bagdad, it was called an apothecary. These apothecaries were used as places to fill some sort of prescriptions, much like our pharmacists do today. Do you want to see what a prescription then might have looked like?
I grinned excitedly at Melissa. "Yes!"
Melinda handed me a small sheet of paper, it looked like a copy out of a book. (prescription).
"I made that copy for you out of an old textbook of mine. It was also during this medieval time that formulas and dosages amounts became common practice (Moini, 4)."
"Well, then clearly medieval medicine cannot be viewed solely in a primitive Dark Age viewpoint, but rather as a structured system of practice!" I guess I would have to wait to learn some more about the history of pharmacy. A customer walked up to the counter. I wondered what Melinda would have for me next time.
Bibliography
Primary Sources
Dioscorides, "Book One: Aromatics", De Matena Medica http://www.cancerlynx.com/BOOKONEAROMATICS.PDF.
Chaucer, Geoffrey. The Canterbury Tales. http://www.librarius.com/canttran/gptrfs.htm
Hippocratic,
On the Nature of Man, On the Sacred
Disease, Hippocratic Oath. http://homepage.mac.com/kvmagruder/hsci/05-Hellenistic/hippocrates.html.
Secondary Sources
Benedictow, OLE J. The Black Death 1346 - 1353: The Complete History. (Boydell & Brewer, 2004).
Lindberg, David. The Beginnings of Western Science. (Chicago: The University of Chicago, 1992).
Magner, Lois N. A History of Medicine. (New York: Marcel Dekker, Inc.) 1992
Moini, Jahangir. The Profession and Practice of Pharmacy Technicians: A Comprehensive Approach. (Thomson Delmar Learning, 2004)
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